在申请参加电离辐射条件下工作的劳动适龄人口中,老年黄斑变性的流行率:初步结果。

Yu Yefimova, P Fedirko, T Babenko, R Dorichevska
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引用次数: 0

摘要

近几十年来,为确定视网膜变性疾病在全球的流行情况,开展了几次大规模的眼部流行病学调查(如蓝山眼科研究)。对这些研究结果的评估历时数十年,研究本身需要大量的物质资源。这项工作的目的是研究非辐照工作年龄人群中老年黄斑变性的患病率,以确定是否适合将研究结果用于乌克兰的进一步流行病学研究:对试点人群视网膜退行性疾病的患病率进行了回顾性-前瞻性分析,这些人声称参加了有害条件(电离辐射)下的工作,并接受了深入检查。随机抽取了 2007 年 1 月 18 日至 2009 年 10 月 29 日期间对 1 064 人进行的初级眼科检查结果。受检者接受检查时的年龄介于 18.94 岁至 67.49 岁之间,18 至 30 岁、30 至 40 岁和 40 至 50 岁的人数大致相同。检查结果采用标准化眼科检查结果:在处于工作年龄的试点人群中,老年性黄斑变性的发病率为每千人中 196.4 例。危险分析显示,年龄相关性黄斑变性的相对风险随着年龄的增长而增加,30-39 岁人群的相对风险为 1.14(95% CI 1.07-1.21);30 岁以下人群的相对风险为 1.3(95% CI 1.21-1.41);40-49 岁人群的相对风险为 1.3(95% CI 1.18-1.52);50-59 岁人群的相对风险为 1.3(95% CI 1.18-1.52);60 岁以上人群的相对风险为 1.86(95% CI 1.0-3.47)。与年龄小于 30 岁的人相比,年龄在 30-39 岁的人患老年性黄斑变性的几率比(OR)为 3.04(95% CI 1.79-5.15);年龄在 40-49 岁的人为 5.49(95% CI 3.31-9.09);年龄在 50-59 岁的人为 5.49(95% CI 1.0-3.47)。09);50-59 岁的人--6.04(95% CI 3.36-10.88);50-59 岁的人--6.04(95% CI 3.36-10.88),60 岁以上的人--13.71(95% CI 3.68-51.15),所有情况下的 p 均小于 0.0001:试验组确定,未接受过放射治疗的人中老年性黄斑变性的发病率很高,而且在统计学上随着年龄的增长而显著增加。研究表明,对申请参加有害条件(电离辐射)工作的试点人群进行眼科初检的结果,适用于对乌克兰工作年龄人群视网膜退行性疾病的发病率和病程进行流行病学研究。获得的结果对实用医学非常重要,因为这些结果将使我们能够评估二级和三级医疗保健的前景需求。
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PREVALENCE OF AGE-MACULAR DEGENERATION IN PERSONS OF WORKING AGE WHO APPLIED TO PARTICIPATE IN WORK IN ACTION CONDITIONS IONIZING RADIATION: PRELIMINARY RESULTS.

In recent decades, several large-scale epidemiological surveys of the eyes have been conducted to determine the global prevalence of retinal degenerative diseases (for example, the Blue Mountains Eye Study). The results of such studies were evaluated several decades, and the studies themselves required significant material resources. Such large-scale projects have not been carried out in Ukraine.Objective of the work is to study the prevalence of age-related macular degeneration in a pilot group of non-irradiated persons of working age to determine the suitability of using the results for further epidemiological studies in Ukraine.

Materials and methods: A retrospective-prospective analysis of the prevalence of degenerative diseases of the retina in a pilot group of persons who underwent an in-depth examination, as they claimed to participate in works in harmful conditions (with ionizing radiation) was carried out. The results of primary ophthalmological examinations of 1,064 people, conducted between January 18, 2007 and October 29, 2009, were randomly selected. The age of the examinees at the time of examination ranged from 18.94 to 67.49 years, the number of persons aged 18 to 30, 30 to 40, and 40 to 50 years was approximately the same. The results of a standardized ophthalmological examination were used.

Results: In the pilot group of people in working age, the prevalence of age-related macular degeneration was 196.4 per 1,000 people. Hazard analysis showed that the relative risk of age-related macular degeneration increased with age and was 1.14 (95% CI 1.07-1.21) for individuals aged 30-39 years; in comparison with persons under the age of 30; 1.3 (95% CI 1.21-1.41) - for persons aged 40-49; 1.3 (95% CI 1.18-1.52) - for persons aged 50-59; 1.86 (95% CI 1.0-3.47) - for persons over 60 years of age. The odds ratio (OR) of having age-related macular degeneration for those aged 30-39 years compared with those younger than 30 years was 3.04 (95% CI 1.79-5.15); for persons aged 40-49 years - 5.49 (95% CI 3.31-9.09); for persons aged 50-59 years - 6.04 (95% CI 3.36-10.88); for persons aged 50-59 years - 6.04 (95% CI 3.36-10.88) and for persons older than 60 years - 13.71 (95% CI 3.68-51.15), p in all cases < 0.0001.

Conclusions: It was established that the prevalence of age-related macular degeneration in non-irradiated individuals determined in the pilot group was high and statistically significantly increased with age. It is shown that the results of primary ophthalmological examinations of a pilot group of persons who applied for participation in works in harmful conditions (with ionizing radiation) are suitable for epidemiological studies of the frequency and course of degenerative retinal diseases in persons of working age in Ukraine. The obtained results are important for practical medicine, as they will allow us to assess the prospects needs for medical care in the secondary and tertiary care.

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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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